gefitinib (Oral route)

ge-FI-ti-nib

Commonly used brand name(s):

In the U.S.

• Iressa

Available Dosage Forms:

• Tablet

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Tyrosine Kinase Inhibitor

Uses For gefitinib

Gefitinib belongs to the group of medicines called antineoplastics. It is used to treat non-small cell lung cancer after the failure of other chemotherapy treatment.

Before you begin treatment with gefitinib, you and your doctor should talk about the good gefitinib will do as well as the risks of using it.

gefitinib is available only with your doctor's prescription.

Before Using gefitinib

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For gefitinib, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to gefitinib or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on gefitinib have been done only in adult patients, and there is no specific information comparing use of gefitinib in children with use in other age groups.

Geriatric

gefitinib has been tested in elderly patients and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Using gefitinib with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Vinorelbine

Using gefitinib with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Itraconazole
• Ketoconazole
• Phenytoin
• Ranitidine
• Rifampin
• Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of gefitinib. Make sure you tell your doctor if you have any other medical problems, especially:

• Idiopathic pulmonary fibrosis—Condition may worsen while receiving gefitinib therapy

• Kidney disease or
• Liver disease—The chance of serious side effects is greatly increased.

Proper Use of gefitinib

Dosing

The dose of gefitinib will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of gefitinib. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form:
  • For lung cancer, non-small cell:
    • Adults—250 milligrams (mg) daily.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of gefitinib, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Precautions While Using gefitinib

It is very important that your doctor check your progress at regular visits to make sure that gefitinib is working properly and to check for unwanted effects.

It is very important to check with your doctor if you have diarrhea, nausea or anorexia.

It is very important to check with your doctor if you have problems breathing.

It is very important to check with your doctor if you have any new eye problems.

gefitinib Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• bloating or swelling of face, arms, hands, lower legs, or feet
• burning, dry or itching eyes
• change in vision
• difficult or labored breathing
• eye discharge or excessive tearing
• redness, pain, swelling of eye, eyelid, or inner lining of eyelid
• shortness of breath
• tightness in chest
• tingling of hands or feet
• unusual weight gain or loss
• wheezing

• abnormal eyelash growth
• blistering, peeling, loosening of skin
• bloating of stomach
• blood in urine
• bloody nose
• chills
• constipation
• cough
• darkened urine
• diarrhea
• fainting or loss of consciousness
• fast heartbeat
• fast or irregular breathing
• fever
• indigestion
• joint or muscle pain
• large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
• loss of appetite
• nausea
• pains in stomach, side, or abdomen, possibly radiating to the back
• redness, tenderness, itching, or burning of skin
• seeing floating spots before the eyes
• severe stinging of the eye
• skin rash
• sore throat
• sores, ulcers, or white spots in mouth or on lips
• unusual tiredness or weakness
• vomiting
• yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

• Diarrhea
• skin rash

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• blemishes on the skin, pimples
• lack or loss of strength
• dry skin

• irritation or soreness of mouth
• blisters under the skin, large, hard skin blisters

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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